The comparison of retinal findings in end stage of CKD and in diabetic renal failure / Шинэ санаа Шинэ нээлт

Background@#Retinal pathologic features are associated with inflammatory processes and endothelial dysfunction, leading to circulatory abnormalities and reduced vascular reactivity. Both retinopathy and nephropathy involve thickening of basement membrane and muscular layers and increased leakage. These pathologic and hemodynamic abnormalities may occur throughout the body and their effects on the retinal vasculature may be useful indicators of cumulative microvascular damage from hypertension, inflammation, diabetes mellitus, and other processes. Type 2 MPGN is an uncommon renal condition associated with electron dense deposits in the lamina densa of the glomerular basement membrane with C3 found in the capillary loops and mesangium. The deposits in the basement membrane can lead to a breakdown of the blood-retinal barrier by interfering with the RPE layer, and type 2 MPGN has been described in association with central serous retinopathy.@*Purpose@#To assess the retinal findings in end stage of Chronic kidney disease (CKD) and diabetic renal failure@*Methods@#Data of diabetic renal failure (n=20, mean age 56.8±11.6), and end stage of CKD(n=83, mean age 48.2± 11.6) were cross-sectional analyzed. Nonmydriatic fundus photographs of the disc and macula in both eyes were obtained in all the subjects. The photographs were assessed by ophthalmologist using the standard protocols. The following parameters were recorded: BCVA, IOP, BP GFR, serum Creatinine, ophthalmic and fundus examination.@*Results@#Greater severity of retinopathy was associated with DM. The presence of vascular abnormalities usually associated with Diabetes Mellitus ( DM) and was not associated with lower estimated glomerular filtration rate. All of patients with DM (n=20, 100%) ,they have Diabetic retinopathy. We found sight direct relationship between retinal posterior pole deposit with CKD patients. Some of patients who have end stage of CKD, (n=18, 11%) they have retinal deposit on their posterior pole.@*Conclusion@#Our findings show ,In participants with end stage of CKD, there was no significant severe retinopathy. In summary, our study demonstrates that DM, is one of the leading cause of irreversible vision loss. Every patients with DM need the ophthalmic follow up examination in every six months.

Surgical treatment and survival rate from colorectal cancer in Mongolia / Монголын Анагаах Ухаан

Introduction@#In 2018, the overall colorectal cancer (CRC) incidence rate was 3.6%, according to the National Cancer Center of Mongolia (NCCM), and the incidence of colorectal cancer has increased slightly in recent years. According to cancer stages, late stage cancer has a 5-year survival rate of 51%, while early stage cancer has a 5-year survival rate of 79%. The overall survival rate of colorectal cancer in Mongolia has not been studied in precisely. In Asia, the 5-year survival rate for colorectal cancer was 60%. Therefore, this study investigated the colorectal cancer survival rate and prognostic factors at NCCM.@*Methods@#A total of 108 patients diagnosed with CRC at NCCM’s General Surgery Department from 2013 to 2015 were used in this retrospective cohort study. The Kaplan-Meier method was used to develop the survival graphs, which were then compared using the Log-rank test.@*Results@#The median survival time was 42 months, with a 95% CI (38.55-45.66). A 5-year period, the overall survival rate for CRC was 61.2%. Survival rates at the I, II, III, and IV stages were 100%, 75%, 65.4%, and 13.5%, respectively. There was a significant difference in CRC survival rates across all stages (p=0.0001). There was a statistically significant difference in determining the relationship between adjuvant chemotherapy and survival rate (p=0.0003).@*Conclusion@#The outcome of the surgery is determined by the CRC stage. The postoperative survival rate (61.2%) is directly related to tumor stage, peripheral glandular metastasis, distant metastasis, and chemotherapy effects.

Comparison of recent years’ incidences of congenital hip dislocation and developmental dysplasia of the hip among children / Монголын Анагаах Ухаан

BackgroundChildren’s congenital hip dislocation is ranked first, accounting for 49,4% among other skeletal anomalieswhich cause to physical disability.There is a tendency that the number of newborn with the congenitalhip dislocation is going to be increased in recent years, 5000:1 were in 1976 and 1000:1,3% in 1998.Bilateral dysplasia accounts for 50-62% of the total incidences. In unilateral cases,left hip seems to beinvolved 2 times more than the right,and the sex ratio is 2,5:1. Some cultures who swaddle their infantstightly with their legs straightened have a far greater incidence of developmental dysplasia of the hip. Aresearch indicated that discouraging this traditional swaddling method has reduced the prevalence ofdevelopmental dysplasia of the hip and congenital hip dislocationby 6 times in America. It is noted thatthis methodhas also been implemented in Japan and Turkey.Aim.This research aimed to study about the prevalence of congenital hip dislocation, developmental dysplasiaof the hip and other anomalies among the children who were underwent treatment at Pediatric Traumaand Orthopedic Department of National Trauma and OrthopedicResearch Centre of Mongolia in 2013-2015 and children served by outpatient visit in the clinics in 2011-2015.The following objectives were defined in the scope of the research. Herein:1. Evaluate and determine the percentage and prevalence of congenital hip dislocation anddevelopmental dysplasia of the hip among the children who undergo treatment in Pediatric Traumaand Orthopedic Departmentof National Trauma Orthopedic Research Center of Mongolia.2. Evaluate and determine the percentage and prevalence of congenital hip dislocation, developmentaldysplasia of the hip and other anomalies among children who are being served by outpatient visit inClinics of National Trauma and Orthopedic Research Center of Mongolia.Materialis and MethodThis research were studied the prevalence of congenital hip dislocation, developmental dysplasia of thehip and other anomalies among the children who were underwent treatment at Pediatric Trauma andOrthopedic Department of National Trauma and OrthopedicResearch Centre of Mongolia in 2013-2015and children served by outpatient visit in the clinics in 2011-2015.ResultTotal of 40559 inpatients underwent treatment in National Trauma andOrthopedic Research of Mongolia;of which 12217 were inpatient in Pediatric Trauma and Orthopedic Department, aged 0-19;of which1351 has been registered with birth defects of hip; of which 248 has been diagnosed with developmentaldysplasia hip, 869 with congenital hip dislocation. Sex ratio of cases of congenital hip dislocationinmales to female is around 1:4.Total of 633 (13,8%) examinations were performed in the clinics in 2011;704 (15,3%) in 2012;962 (20,9%)in 2013;1013 (22%) in 2014;1287 (28%) in 2015 respectively. It shows an increase in the number ofexaminations year by year.Total of 4142 (90,1%) cases were diagnosed with congenital hip dislocation and developmental dysplasiain both hips; left hip has been dislocated 2 times more than the right, 162 (3,5%) with congenitaldislocation of right hip; 292 (6.4%) with congenital dislocation of left hip.ConclusionTo conclude, the analysis above shows that the prevalence of developmental dysplasia of the hip andcongenital hip dislocation is still high in Mongolia. Therefore, number of diagnosis with congenital hipdislocation has rapidly increased in the recent 2 years.

To screen for child emotional and behavioral problems in a community sample / Монголын Анагаах Ухаан

BackgroundIn accordance with WHO investigation, most of the mental disorders onset in childhood and 20 percentof children (1 of fi ve) with mental and behavioral disorder currently. In 2005, by assessment of mentalhealth system in Mongolia (WHO-AIMS) it was concluded that special attention needs to be given todevelop professional competence and services in the area of child and adolescents mental health so itis a reason of the this study.AimTo early identify common emotional and behavioral problems among children and identify risk factorsfor itMethodsThe study was randomly selected 3500 child aged between from 4 to 17 years in 5 districts of Ulaanbaatarcity and 46 soums of 11 aimags of Mongolia.A main tool is Strengths and Diffi culties Questionnaire (SDQ) and included the 25-item child andparent versions were used to record each informant’s perception of four problem domains/subscales.SDQ was differently used child ages such as child aged 6-10 years used by parent version child agedbetween11-17 years used by both child and parent versions.ResultsOf 2920 child who participated in the study, 382 (13%) studied in kindergarten, 2423 (82.9%) school. Anaverage age of participants was 10.9±4.ConclusionThe abnormal emotional reaction was dominantly occurred in urban girls aged between from 6 to 10years and the abnormal behavioral reaction was dominantly occurred in urban boys aged between from6 to 15 years. The family relationship was a risk factor for developing emotional and behavioral problemsin child.

Needs assessment of faculties’ development on teaching methodology at MNUMS / Шинэ санаа Шинэ нээлт

Regardless the possession of any graduation and qualifications anywhere in order to train the doctors and medical professionals with the capabilities to work in any places there are the needs of the knowledgeable mentors to teach their knowledge, abilities and trends to the students in national, regional and international levels. This survey was started to determine the needs of the skills development of the mentors of the Mongolian National University of Medical Sciences under the mission to make it as one of the best 100 medical universities in the Asia-Pacific region and in order to create the favorable environment to accelerate the development of the university and creating a team consists from qualified mentors and researchers by improving the trainings, researches and clinical favorable environment including the quality improvement of the activities.The total of 333 mentors from the 5 structures and 3 branches of the Mongolian National University of Medical Sciences were surveyed to be developed by the University of Michigan including the use of the widely used questionnaires in the universities consisting from 7 groups and 81 questions to determine the needs of the mentors.The working range of the best medical mentors including their needs of the skills was studied. The 55.7% (50.4-61.0%) of the mentors included in the survey were told that the facilitation of the learning needed, 82.4% (78.3-86.5%) as the role models needed, 79.9% (75.6-84.2%) as the provision of the information is needed, 76.3% (71.7-80.9%) as 82.8% (78.8-86.9%) as the planning needed and 81.0% (76.8-85.2%) as the assessment of the training is needed.There is a need to develop the skills related to the 6 frameworks as the learning facilitation for the mentors, role model providers, information providers, resource developers, planners and assessors.

Assessment of contents of the “Community based rehabilitation” curriculum / Шинэ санаа Шинэ нээлт

In our country for developing these services closer to the population, providing home care and treatment can be conducted in order to get the patient’s health care refer to the family and sum based health centers should be carried out. At the family and sum hospitals are working graduators of medical university, who assisting health care of Community based rehabilitation. In those cases adoctor have a role to give health care services, and to mediate between disabled people and other health care services as physical therapy, speech therapy, prosthesis and orthotics care, disability surgery and other professional cares. Therefore, there is needs to determine training needs of Community based rehabilitation and to accommodate with study curriculum.To evaluate the curriculum content, retrospective databases and descriptive research method were used and research data was collected by previous data analysis, interview and surveillance.In the result, contents of the “Community based rehabilitation” curriculum in different medicaluniversities are generally the same. But the curriculum was more attached to the disease and its drug medications rather than reflecting to proper guidance and advice for patients and main idea of “Community based rehabilitation”. Availability of specific textbooks and handbooks is limited, hence the trainings are held using international declaration, annual report or guidelines. Also the specialists who teach the subject were inadequate. Relating the due subjects, teaching methods were various, such as problem solving and small group discussion, case study etc., and students were evaluated bytest, case solving, essay writing and for School of Medicine, MNUMS they use OSCE. In conclusion, content of the “Community based rehabilitation” curriculum in undergraduate medical education is not adequate, indefinite, and discordant and there is lack of specialized teachers. Additionally, the curriculum content was not applied to the WHO guidance. Therefore we developed“Community based rehabilitation” curriculum in each medical disciplines, available to be used in undergraduate medical education in further.

EVALUATION OF THE SECONDARY SCHOOL EXTERNAL ENVIRONMENT SOLID WASTE MANAGEMENT IN ULAANBAATAR MONGOLIA / Шинэ санаа Шинэ нээлт

A school environment may cause positive effect upon health and healthy behavior, but also representmain factor for transfer of non-infectious diseases. Therefore, the issue of maintaining an appropriate environment in operations of training and educational institution would be considered as vital in every country of the world. In our country the solid waste hygienic conditions around children organizations represent one of actual problems. Through the research work was aimed to evaluate the state of solid waste at external environment of general educational institutions by the momentum model of analytical research and involving 103 state proprietary Educational Institutions of 9 districts. At developing estimation list of solid waste at external environment of schools were used current effective standards, resolutions and regulations. 88.3 percent of schools involved into research work had special solid waste-points and 11.7 percent had no special solid waste-points. 38.8 percent of solid waste-points were fenced from all sidesand 44.7 percent fenced from some sides and 16.5 percent had no fence in whole. The research of material from which was made a solid waste-keeping facility showed that 44.2 percent were made from metal, 2.3 percent from wood and 52.3 percent from brick. When we studied whether the solid waste-keeping facility is placed in distance of 25 meters from school according to standard,was determined that 71.8 percent were built according to the standard, 28.2 percent were allocated within 25 meters showing inconformity with the standard. During the research it has been detected that among schools 27.2 percent had too much solid waste-heap, 25.5 percent had placed no special recycle-bins on the school site and 13.6 percent conducted wrong activity by incinerating solid waste on the territory of school.2/3 or total 63 schools among Metropolitan state proprietary educational institutions has non- standard solid waste-keeping facility, 1/3 or 29 schools has located their solid waste-points in non- standard distance, there exists much solid waste-heap because of insufficient recycle-bins, absence of solid waste-points results in collection of solid waste in a special room inside of school and later its transportation with scavenger. Also, 13.6 percent or 14 schools are incinerating their solid waste within school site. This breeches effective hygienic norms and normative.

USING THE STRENGTHS AND DIFFICULTIES QUESTIONNAIRE (SDQ) TO SCREEN FOR CHILDREN BETWEEN 11-17 YEARS OLD IN A COMMUNITY SAMPLE / Шинэ санаа Шинэ нээлт

Child psychiatric disorders are common and treatable, but often go undetected and therefore remain untreated.To assess the Strengths and Difficulties Questionnaire (SDQ) as a potential means for improving the detection of child psychiatric disorders in the community.SDQ predictions and independent psychiatric diagnoses were compared in a community sample of 1959 11- to 17-year-olds from the 2013 Mongolian National Center for Mental HealthMulti-informant (parents, teachers, older children) SDQs identified individuals with a psychiatric diagnosis with a specificity of 66.8% (95% Cl 61.4-73.0%) and a sensitivity of 64.4% (59.9-71.3%). The questionnaires identified over 65% of individuals with conduct, hyperactivity, depressive and some anxiety disorders. Sensitivity was substantially poorer with single-informant rather than multi-informant SDQs.Community screening programmers based on multi-informant SDQs could potentially increase the detection of child psychiatric disorders, thereby improving access to effective treatments

Knowledge of rural herdsmen on non-communicable diseases and their needs in and availability of information / Монголын Анагаах Ухаан

IntroductionAs prevalence of morbidity and mortality due to the non-communicable diseases is high, educationand communication are crucial in terms of reduction of the risk factors of these diseases amongstthe population. However, the sources and needs for information regarding NCDs among the generalpopulation, especially among the rural herdsmen, are still unknown.Materials and MethodsThe study used a population based cross sectional design selecting 500 herders in total by themultistage random cluster sampling method from 4 provinces and 12 soums of 4 the geographicalregions of Mongolia. Data collection methods included both quantitative and qualitative methodsfollowed by an analysis of the data using the by SPSS 17.0 software.ResultsA total of 228 herding families participated in the study and 78.5% of them were use television, 37.3%--radio and 10.1% -- newsletters. As for sources of health information, 53.4% of participants receiveinformation on NCDs from the television, 32.2% - from health care facilities, and 18.6% -- from radio.More than 65% of the participants state that the information on NCDs is “insufficient”, whereas 92%have never participated in trainings on NCDs, and 84.4% were have had no access to NCD-relatedbrochures and handouts. These results indicate that the NCD related information available to theherders and rural population is insufficient. In terms of demand for information on non-communicablediseases, 82.2% of the respondents answered that information is necessary, 60.4% of the herdersprefer to have information through television, 42.2%-- through soum doctors and bag feldschers,35.8%-- from health care facilities, and 31.4% -- from the radio.ConclusionInformation on NCDs available to rural herders and households is insufficient, thus more appropriatemethods for delivery NCD information should be used meeting their demands and their preferenceof the sources of health information.